Purpose: To compare the outcomes of preoperative education provided in a noninteractive versus an interactive DVD program.
Design: Experimental.
Sample: Convenience sample of 58 elective joint replacement patients.
Method: Subjects were randomly assigned to the video or DVD group. Measurements included posteducation test of knowledge, patient satisfaction questionnaire, and postdischarge collection of data on physical therapy participation, complications, pain behaviors, and length of stay.
Findings: Participants in the DVD group had statistically higher knowledge scores and significantly more physical therapy visits. No statistical significant differences were noted in pain behaviors, rate of complications, patient satisfaction, or length of stay.
Implications: As our society continues to develop computer technology, opportunities for health care organizations to partner with businesses in developing new-age patient education programs will increase. Further study is needed to establish the efficacy of DVD instruction (versus other educational approaches) on postoperative clinical outcomes. Testing on larger samples and with other surgical conditions would be valuable.
Preoperative preparation is a standard function of nurses who work in surgical and procedural areas. It is an essential responsibility of nursing care. Supporting this function is one of the most long-standing, prolific, and applied areas of nursing research (Schwartz-Barcott, 1994). Patients who receive preoperative education have a reduced anxiety level and shorter length of stay; they also show improvement in postoperative outcomes (Devine & Cook, 1983; King & Tarsitano, 1982).
For preoperative education to be effective, nurses must respond to the learning needs of the patients and adjust educational strategies according to ongoing assessments of learning styles and preferences. With ongoing computer and technology advances, the learning needs and preferences of the health care consumer have become more sophisticated.
With more information openly available via the Internet, many consumers have become accustomed to an interactive exchange of information with immediate feedback. They are able to individualize the information through visual and auditory means and at the same time either streamline or repeat the exchange of data.
Moreover, advances in the entertainment field also raise the expectations of the health care consumer for the format and presentation of educational information. A variety of formats are currently used to educate patients, including one-to-one instruction, demonstrations, printed materials, and videotapes.
At St. Luke's Medical Center in Milwaukee, an opportunity arose to partner with a new vendor in the production of a state-of-the-art preoperative videotape using digital video disc (DVD) technology. An interdisciplinary group updated the current preoperative education videotape script. Care was taken to develop a user-friendly, touch-screen format that allowed the patient and family to interact with selected portions of the teaching program. Figure 1 provides information on DVD technology.
The primary goal of this project was to compare the effectiveness of noninteractive videotape and interactive DVD approaches to education. Each approach provided the same content and was used for preoperative education for patients (and their families) undergoing either a total knee or total hip joint replacement. It was hoped that this new technology would increase short-term knowledge, increase satisfaction, and provide information to increase the patient's level of participation in postoperative activities, while providing immediate feedback during the learning experience.